Loan Application

(IMPORTANT: This Loan application is for CURRENT WVFCU MEMBERS ONLY, if you are NOT a member yet and would like to apply click here for a printable PDF application that will need to be completed and signed by the applicant(s) and delivered to one of our convenient locations to be processed.)

If you answer "Yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.

Applicant

Name:

Social Security Number:

Driver's License Number:

Driver's License State:

Date of Birth:

Date of Birth: Month / Date of Birth: Day / Date of Birth: Year

Ages of Dependents:

Email Address:

Home Phone Number:

Work Phone Number:

Complete Marital Status for joint credit, secured credit, or if you live in a community property state.

Marital Status:

married

separated

unmarried (single / divorced / widowed)

Applicant - Current Residence

Street Address:

Apt:

City:

State:

Zip Code:

Residence Type:

Rent

Own

Length at Residence:

Applicant - Employment/Income

Company:

Company Address:

Title/Grade:

Start Date:

Hours at Work:

If self-employed, type of business:

Employment Income:

Income is per:

year

month

hour

Income:

Net

Gross

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered.

Other Income:

Income is per:

year

month

hour

Income:

Net

Gross

Reference

Name and address of nearest relative not living with you.

Name:

Street Address:

Apt:

City:

State:

Zip Code:

Relationship:

Home Phone:

Other

Other Applicant is::

Co-Applicant

Spouse

Other

Name:

Social Security Number:

Driver's License Number:

Driver's License State:

Date of Birth:

Date of Birth: Month / Date of Birth: Day / Date of Birth: Year

Ages of Dependents:

Email Address:

Home Phone Number:

Work Phone Number:

Complete Marital Status for joint credit, secured credit, or if you live in a community property state.

Marital Status:

married

separated

unmarried (single / divorced / widowed)

Other - Current Residence

Street Address:

Apt:

City:

State:

Zip Code:

Residence Type:

Rent

Own

Length at Residence:

Applicant - Employment/Income

Company:

Company Address:

Title/Grade:

Start Date:

Hours at Work:

If self-employed, type of business:

Employment Income:

Income is per:

year

month

hour

Income:

Net

Gross

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered.

Other Income:

Income is per:

year

month

hour

Income:

Net

Gross

Reference

Name and address of nearest relative not living with you.

Name:

Street Address:

Apt:

City:

State:

Zip Code:

Relationship:

Home Phone:

What You Owe: 1, Creditor Name other than this CU:

What You Owe: 1, Interest Rate:

What You Owe: 1, Present Balance:

What You Owe: 1, Monthly Payment:

What You Owe: 1, Owed by Applicant or Other:

What You Owe: 2, Creditor Name other than this CU:

What You Owe: 2, Interest Rate:

What You Owe: 2, Present Balance:

What You Owe: 2, Monthly Payment:

What You Owe: 2, Owed by Applicant or Other:

What You Owe: 3, Creditor Name other than this CU:

What You Owe: 3, Interest Rate:

What You Owe: 3, Present Balance:

What You Owe: 3, Monthly Payment:

What You Owe: 3, Owed by Applicant or Other:

What You Owe: 4, Creditor Name other than this CU:

What You Owe: 4, Interest Rate:

What You Owe: 4, Present Balance:

What You Owe: 4, Monthly Payment:

What You Owe: 4, Owed by Applicant or Other:

What You Owe: 5, Creditor Name other than this CU:

What You Owe: 5, Interest Rate:

What You Owe: 5, Present Balance:

What You Owe: 5, Monthly Payment:

What You Owe: 5, Owed by Applicant or Other:

What You Owe: 6, Creditor Name other than this CU:

What You Owe: 6, Interest Rate:

What You Owe: 6, Present Balance:

What You Owe: 6, Monthly Payment:

What You Owe: 6, Owed by Applicant or Other:

What You Owe: 7, Creditor Name other than this CU:

What You Owe: 7, Interest Rate:

What You Owe: 7, Present Balance:

What You Owe: 7, Monthly Payment:

What You Owe: 7, Owed by Applicant or Other:

What You Owe: 8, Creditor Name other than this CU:

What You Owe: 8, Interest Rate:

What You Owe: 8, Present Balance:

What You Owe: 8, Monthly Payment:

What You Owe: 8, Owed by Applicant or Other:

What You Owe: 9, Creditor Name other than this CU:

What You Owe: 9, Interest Rate:

What You Owe: 9, Present Balance:

What You Owe: 9, Monthly Payment:

What You Owe: 9, Owed by Applicant or Other:

What You Owe: 10, Creditor Name other than this CU:

What You Owe: 10, Interest Rate:

What You Owe: 10, Present Balance:

What You Owe: 10, Monthly Payment:

What You Owe: 10, Owed by Applicant or Other:

What You Own: 1, location of Property or Financial Institution:

What You Own: 1, Market Value:

What You Own: 1, Pledged as collateral for another loan?

What You Own: 1, Owned by Applicant or Other:

What You Own: 2, location of Property or Financial Institution:

What You Own: 2, Market Value:

What You Own: 2, Pledged as collateral for another loan?

What You Own: 2, Owned by Applicant or Other:

What You Own: 3, location of Property or Financial Institution:

What You Own: 3, Market Value:

What You Own: 3, Pledged as collateral for another loan?

What You Own: 3, Owned by Applicant or Other:

What You Own: 4, location of Property or Financial Institution:

What You Own: 4, Market Value:

What You Own: 4, Pledged as collateral for another loan?

What You Own: 4, Owned by Applicant or Other:

What You Own: 5, location of Property or Financial Institution:

What You Own: 5, Market Value:

What You Own: 5, Pledged as collateral for another loan?

What You Own: 5, Owned by Applicant or Other:

What You Own: 6, location of Property or Financial Institution:

What You Own: 6, Market Value:

What You Own: 6, Pledged as collateral for another loan?

What You Own: 6, Owned by Applicant or Other:

Other Information About You

<p>Are you a U.S. citizen or permanent resident alien?</p>

Applicant:

Other:

<p>Do you currently have any outstanding judgments or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been a party in a lawsuit?</p>

Applicant:

Other:

Is your income likely to decline in the next 2 years?

Applicant:

Other:

Are you a co-maker, so-signer or guarantor on any loan not listed above?

Applicant:

If yes, for whom:

If yes, to whom:

Other:

If yes, for whom:

If yes, to whom:

Patriot Act

State Law Notices

Ohio Residents Only: the Ohio laws against discrimination require that all creditors make credit available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. the Ohio civil rights commission administers compliance with this law.

Wisconsin Residents Only: (1) No provision of any marital property agreement unilateral statement under Section 766.59, or course decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished with a copy of the agreement, statement or decree, or has actual knowledge of the terms, before the credit is granted or the account is opened. (2) Please intial below if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.

Initials for Wisconsin Residents Only:

Agreement

Initial below to promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify us in writing immediately. You authorize the West Virginia Federal Credit Union to obtain credit reports in connection with the application for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the West Virginia Federal Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a Federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.